Provider Demographics
NPI:1134199466
Name:JESSICA HALPRIN MD PC
Entity type:Organization
Organization Name:JESSICA HALPRIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPRIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-601-2941
Mailing Address - Street 1:3333 HENRY HUDSON PARKWAY
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:RIVERDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:718-601-2941
Mailing Address - Fax:718-601-8068
Practice Address - Street 1:3333 HENRY HUDSON PARKWAY
Practice Address - Street 2:SUITE 1H
Practice Address - City:RIVERDALE
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:718-601-2941
Practice Address - Fax:718-601-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS200635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF27461Medicare UPIN